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Before we discuss this issue, we need to understand the anatomy of your tooth. Starting from the center, your tooth has nerves and blood vessels in the middle of it. Immediately surrounding it and making up most of the core of your tooth is something called dentin. This dentin is a semi-hard material that helps absorb shock and provides a great deal of thermal resistance(hot and cold sensations). The last and most outer layer of the tooth is called the enamel. This is the hardest material in your body and acts to protect the tooth. 

Our teeth are so strong. They’re designed to function for our entire lifetime. But for so many people, this does not hold true. Because our diets have changed so much over our existence, modern diets are filled with so many things, like sugar, that cause our teeth to get tooth decay. When we get decay, we get what we call fillings to help us preserve our teeth. For the most part, this does the trick. But sometimes, our decay compromises the tooth too much, and things start to break. The best way to explain this is to compare it to the roof of a house. A roof protects the house from the elements, but over time you may develop leaks, and the roof may need to be patched. After so many patches, the roof might become too compromised. Your roofer might advise you to get a new roof. But how does this compare to a tooth? Remember the layers? Your enamel is your roof! But can you replace your enamel? Not exactly, but in a way. That is what a dental crown is, a new strong covering over your tooth, like enamel. Interestingly, in the past, we used to cover the tooth with metal, gold at one point was everyone’s favorite. As the market demanded more aesthetically pleasing tooth-colored crowns, we started to fuse porcelain on top of the metal. Modern dentistry now has porcelain-like ceramics that can be as strong as some metals and has helped us avoid metal altogether.

The first step is to perform a crown preparation that sometimes is accompanied by a core build-up. A crown basically replaces the enamel, and a core build-up basically replaces the dentin. Before a new crown is cemented in permanently, a temporary and removable crown is made. The patient should be asked to wear this temporary crown for at least 2 weeks. This is a great evaluation period. If all goes well that the issue is over, and the final crown is cemented in permanently. If the tooth still has issues, then something called a root canal should be performed. 

Just like a crack in your windshield, it depends on how unlucky you are. The sooner the crack is detected and repaired, the better the chances. Just like a crack in your windshield, if you ignore it, then over time, it will grow and spread. Eventually, the problem gets worse, and the only option is removal and replacement. And just like most mechanics will tell you, there’s nothing like the seal on that original windshield. Your dentist would tell you the same about your tooth.